| Keith E Jackson, CRNA | |
|
100 Rice Mine Rd N, Tuscaloosa, AL 35406-2300 | |
| (205) 354-0010 | |
| Not Available |
| Full Name | Keith E Jackson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 26 Years |
| Location | 100 Rice Mine Rd N, Tuscaloosa, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205866142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 1-080730 (Alabama) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Clay County Hospital | Ashland, AL | Hospital |
| Clay County Hospital | Ashland, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Patriot Perioperative Partners, Inc | 4789964859 | 2 |
| Clay County Healthcare Authority | 5193700797 | 9 |
| Entity Name | Clay County Healthcare Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477551554 PECOS PAC ID: 5193700797 Enrollment ID: O20040618001157 |
| Entity Name | Patriot Perioperative Partners, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386194454 PECOS PAC ID: 4789964859 Enrollment ID: O20161207000089 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith E Jackson, CRNA 712 Robin Rd, Birmingham, AL 35214-3524 Ph: (205) 213-8420 | Keith E Jackson, CRNA 100 Rice Mine Rd N, Tuscaloosa, AL 35406-2300 Ph: (205) 354-0010 |
Kathy Taylor Givhan, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 809 University Blvd E, Tuscaloosa, AL 35401 Phone: 205-759-7352 Fax: 205-759-6397 |
Johnna Junkin Walker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 809 University Blvd E, Tuscaloosa, AL 35401 Phone: 205-759-7352 Fax: 205-759-6397 |
Melinda Banks Bell, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 809 University Blvd E, Tuscaloosa, AL 35401 Phone: 205-759-7352 Fax: 205-759-6397 |
Tonya Via, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 809 University Blvd E, Tuscaloosa, AL 35401 Phone: 205-759-7755 |
Marina Christine Williams, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 809 University Blvd E, Tuscaloosa, AL 35401 Phone: 205-759-7352 Fax: 205-759-6397 |
James Robert Crowe, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 809 University Blvd E, Tuscaloosa, AL 35401 Phone: 205-759-7352 Fax: 205-759-6397 |
Mr. Joseph Lee Stork Jr., CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 809 University Blvd E, Tuscaloosa, AL 35401 Phone: 205-759-7111 |